Identifying risk factors of anemia among women of reproductive age in Rwanda – a cross-sectional study using secondary data from the Rwanda demographic and health survey 2014/2015

Abstract

BackgroundAnemia among Women of Reproductive Age (WRA) continues to be among the major public health problems in many developing countries, including Rwanda, where it increased in prevalence between the 2015 and 2010 Rwanda Demographic and Health Survey (RDHS) reports. A thorough understanding of its risk factors is necessary to design better interventions. However, to the best of our knowledge, no study has been conducted in Rwanda on a nationally representative sample to assess factors associated with anemia among WRA. Accordingly, this study was conducted to address such gap.MethodsA quantitative, cross-sectional study was conducted using data from the RDHS 2014–2015. The study population consisted of 6680 WRA who were tested for anemia during the survey. Anemia was defined as having a hemoglobin level equal to or below 10.9 g/dl for a pregnant woman, and hemoglobin level equal to or below 11.9 g/dl for a non-pregnant woman. Pearson’s chi-squared test and multiple logistic regression were conducted for bivariate and multivariable analysis, respectively.ResultsThe prevalence of anemia among WRA was 19.2% (95% CI: 18.0–20.5). Four factors were found to be associated with lower odds of anemia, including being obese (OR: 0.61, 95% CI: 0.40–0.91), being in the rich category (OR: 0.74, 95% CI: 0.63–0.87), sleeping under a mosquito net (OR: 0.85, 95% CI: 0.74–0.98), and using hormonal contraceptives (OR: 0.61, 95% CI: 0.50–0.73). Five factors were associated with higher odds of anemia, including being underweight (OR: 1.39, 95% CI: 1.09–1.78), using an intrauterine device (OR: 1.98, 95% CI: 1.05–3.75), being separated or widowed (OR: 1.35, 95% CI: 1.09–1.67), and living in the Southern province (OR: 1.45, 95% CI: 1.11–1.89) or in the Eastern province (OR: 1.41, 95% CI: 1.06–1.88).ConclusionAnemia continues to pose public health challenges; novel public health interventions should consider geographic variations in anemia risk, seek to improve women’s economic statuses, and strengthen iron supplementation especially for Intrauterine device users. Additionally, given the association between anemia and malaria, interventions to prevent malaria should be enhanced.

Anemia and its associated factors among women of reproductive age in eastern Africa: A multilevel mixed-effects generalized linear model

“…Our study also revealed that modern contraceptive use was associated with anemia in women of reproductive age. Using modern contraceptive methods reduces the prevalence of anemia and this is in concordance with different studies [20,32,48]. This is because women who used modern contraceptive methods prevent complications related to pregnancy and childbirth, which could eventually reduce the prevalence of anemia due to recurrent blood loss.…”

“…Even though anemia affects all countries, it mostly affects LMICs especially Asian and Sub-Saharan African countries which accounts for 89% of the anemia burden [19]. In eastern Africa, the prevalence of anemia in women of reproductive age is higher, which ranges from 19.2% in Rwanda to 49% in Zambia [20][21][22][23][24][25][26].…”

Prevalence and determinants of anemia among young (15–24 years) women in Ethiopia: A multilevel analysis of the 2016 Ethiopian demographic and health survey data

“…Women who used modern contraceptives had lower odds of developing anemia as compared to those who didn’t use modern contraceptives. This finding was supported by a study conducted in Rwanda [ 22 ]. This could be justified by the protective effects of modern contraceptives on menstrual bleeding, pregnancy and birth-related hemorrhages [ 23 ].…”

Prevalence and determinants of anaemia in women of reproductive age in Sudan: analysis of a cross-sectional household survey

“…Despite the low number of cases identified as severe anaemia in this study, the overall prevalence does not look different from the WHO estimation for the country and the regional office figure [1,2]. Subnational variation in anaemia prevalence is documented in many countries [29][30][31][32]. This rings the bell for the need to directing available resources to communities in high need as well as to design interventions at local levels based on the gaps and needs.…”

“…In Ethiopia, the prevalence of anaemia in WRA was estimated at 23% [28]. Another good performing African country, Rwanda showed a prevalence of anaemia in WRA of 19.2% [2,29]. Despite this low estimate in Rwanda and the noticeable improvement in maternal health services, the actual situation was showing an increasing trend in anaemia prevalence from a previous level of 17% in 2010 with huge variations at subnational level [29].…”